Age, sex, and socioeconomic differences in multimorbidity measured in four ways : UK primary care cross-sectional analysis
© The Authors..
BACKGROUND: Multimorbidity poses major challenges to healthcare systems worldwide. Definitions with cut-offs in excess of ≥2 long-term conditions (LTCs) might better capture populations with complexity but are not standardised.
AIM: To examine variation in prevalence using different definitions of multimorbidity.
DESIGN AND SETTING: Cross-sectional study of 1 168 620 people in England.
METHOD: Comparison of multimorbidity (MM) prevalence using four definitions: MM2+ (≥2 LTCs), MM3+ (≥3 LTCs), MM3+ from 3+ (≥3 LTCs from ≥3 International Classification of Diseases, 10th revision chapters), and mental-physical MM (≥2 LTCs where ≥1 mental health LTC and ≥1 physical health LTC are recorded). Logistic regression was used to examine patient characteristics associated with multimorbidity under all four definitions.
RESULTS: MM2+ was most common (40.4%) followed by MM3+ (27.5%), MM3+ from 3+ (22.6%), and mental-physical MM (18.9%). MM2+, MM3+, and MM3+ from 3+ were strongly associated with oldest age (adjusted odds ratio [aOR] 58.09, 95% confidence interval [CI] = 56.13 to 60.14; aOR 77.69, 95% CI = 75.33 to 80.12; and aOR 102.06, 95% CI = 98.61 to 105.65; respectively), but mental-physical MM was much less strongly associated (aOR 4.32, 95% CI = 4.21 to 4.43). People in the most deprived decile had equivalent rates of multimorbidity at a younger age than those in the least deprived decile. This was most marked in mental-physical MM at 40-45 years younger, followed by MM2+ at 15-20 years younger, and MM3+ and MM3+ from 3+ at 10-15 years younger. Females had higher prevalence of multimorbidity under all definitions, which was most marked for mental-physical MM.
CONCLUSION: Estimated prevalence of multimorbidity depends on the definition used, and associations with age, sex, and socioeconomic position vary between definitions. Applicable multimorbidity research requires consistency of definitions across studies.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:73 |
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| Enthalten in: |
The British journal of general practice : the journal of the Royal College of General Practitioners - 73(2023), 729 vom: 30. Apr., Seite e249-e256 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
MacRae, Clare [VerfasserIn] |
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| Links: |
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| Themen: |
Epidemiology |
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| Anmerkungen: |
Date Completed 03.04.2023 Date Revised 14.02.2024 published: Electronic-Print Citation Status MEDLINE |
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| doi: |
10.3399/BJGP.2022.0405 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM355021293 |
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| 100 | 1 | |a MacRae, Clare |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Age, sex, and socioeconomic differences in multimorbidity measured in four ways |b UK primary care cross-sectional analysis |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 03.04.2023 | ||
| 500 | |a Date Revised 14.02.2024 | ||
| 500 | |a published: Electronic-Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Authors. | ||
| 520 | |a BACKGROUND: Multimorbidity poses major challenges to healthcare systems worldwide. Definitions with cut-offs in excess of ≥2 long-term conditions (LTCs) might better capture populations with complexity but are not standardised | ||
| 520 | |a AIM: To examine variation in prevalence using different definitions of multimorbidity | ||
| 520 | |a DESIGN AND SETTING: Cross-sectional study of 1 168 620 people in England | ||
| 520 | |a METHOD: Comparison of multimorbidity (MM) prevalence using four definitions: MM2+ (≥2 LTCs), MM3+ (≥3 LTCs), MM3+ from 3+ (≥3 LTCs from ≥3 International Classification of Diseases, 10th revision chapters), and mental-physical MM (≥2 LTCs where ≥1 mental health LTC and ≥1 physical health LTC are recorded). Logistic regression was used to examine patient characteristics associated with multimorbidity under all four definitions | ||
| 520 | |a RESULTS: MM2+ was most common (40.4%) followed by MM3+ (27.5%), MM3+ from 3+ (22.6%), and mental-physical MM (18.9%). MM2+, MM3+, and MM3+ from 3+ were strongly associated with oldest age (adjusted odds ratio [aOR] 58.09, 95% confidence interval [CI] = 56.13 to 60.14; aOR 77.69, 95% CI = 75.33 to 80.12; and aOR 102.06, 95% CI = 98.61 to 105.65; respectively), but mental-physical MM was much less strongly associated (aOR 4.32, 95% CI = 4.21 to 4.43). People in the most deprived decile had equivalent rates of multimorbidity at a younger age than those in the least deprived decile. This was most marked in mental-physical MM at 40-45 years younger, followed by MM2+ at 15-20 years younger, and MM3+ and MM3+ from 3+ at 10-15 years younger. Females had higher prevalence of multimorbidity under all definitions, which was most marked for mental-physical MM | ||
| 520 | |a CONCLUSION: Estimated prevalence of multimorbidity depends on the definition used, and associations with age, sex, and socioeconomic position vary between definitions. Applicable multimorbidity research requires consistency of definitions across studies | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a multimorbidity | |
| 650 | 4 | |a primary care | |
| 650 | 4 | |a socioeconomic disparities | |
| 700 | 1 | |a Mercer, Stewart W |e verfasserin |4 aut | |
| 700 | 1 | |a Henderson, David |e verfasserin |4 aut | |
| 700 | 1 | |a McMinn, Megan |e verfasserin |4 aut | |
| 700 | 1 | |a Morales, Daniel R |e verfasserin |4 aut | |
| 700 | 1 | |a Jefferson, Emily |e verfasserin |4 aut | |
| 700 | 1 | |a Lyons, Ronan A |e verfasserin |4 aut | |
| 700 | 1 | |a Lyons, Jane |e verfasserin |4 aut | |
| 700 | 1 | |a Dibben, Chris |e verfasserin |4 aut | |
| 700 | 1 | |a McAllister, David A |e verfasserin |4 aut | |
| 700 | 1 | |a Guthrie, Bruce |e verfasserin |4 aut | |
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